Approximately 50% of women experience at least one bone fracture postmenopause. Current screening approaches target anti-fracture interventions to women aged >60 years who satisfy clinical risk and bone mineral density criteria for osteoporosis. Intervention is only recommended in 7-25% of those women screened currently, well short of the 50% who experience fractures. Large screening trials have not shown clinically significant decreases in the total fracture numbers. By contrast, six large clinical trials of anti-resorptive therapies (for example, bisphosphonates) have demonstrated substantial decreases in the number of fractures in women not identified as being at high risk of fracture. This finding suggests that broader use of generic bisphosphonates in women selected by age or fracture risk would result in a reduction in total fracture numbers, a strategy likely to be cost-effective. The utility of the current bone density definition of osteoporosis, which neither corresponds with who suffers fractures nor defines who should be treated, requires reappraisal.

中文翻译：

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骨质疏松症干预的更广泛策略。

大约50％的女性在更年期后经历至少一次骨折。当前的筛查方法针对的是满足临床风险和骨质疏松症的骨矿物质密度标准的60岁以上女性的抗骨折干预措施。仅建议在目前接受筛查的女性中，有7-25％的女性采取干预措施，远远低于50％经历骨折的女性。大型筛查试验尚未显示出总骨折数的临床显着减少。相比之下，抗吸收疗法（例如，双膦酸盐）的六项大型临床试验表明，未鉴定为高骨折风险的女性的骨折数量明显减少。这一发现表明，按年龄或骨折风险选择的妇女更广泛地使用仿制双膦酸盐将导致总骨折数量减少，该策略可能具有成本效益。当前对骨质疏松症的骨密度定义的效用既不对应于谁遭受骨折，也不定义应当治疗的人，需要重新评估。